< Millions of women are 'under-muscled.' These foods help build strength

LEILA FADEL, HOST:

More than 45% of older adults in the U.S., especially women, are affected by a condition known as sarcopenia, which is basically a medical term for loss of muscle. U.S. health officials have launched an awareness campaign to highlight the prevalence. The good news is that there are strategies to prevent it. As part of a series on how to thrive as you age, NPR's Allison Aubrey joins us now. Good morning.

ALLISON AUBREY, BYLINE: Good morning, Leila.

FADEL: OK, Allison, so when I was saying sarcopenia, I was like, what am I talking about?

AUBREY: (Laughter).

FADEL: But loss of muscle I might have. Tell us more about what this is exactly.

AUBREY: Well, muscle mass really peaks in our 30s, and then after that, you can slowly start to lose it. And this can really accelerate later in life, which can be a big deal. This really hit home for me this summer when my mother took a bad tumble. Fortunately, she's recovered now, but falls are actually the top cause of death from injury in older people. And I spoke to Dr. Richard Joseph. He's a physician at Brigham and Women's Hospital. He told me loss of muscle strength is really underappreciated.

RICHARD JOSEPH: I would say that as a country, we are under-muscles, for sure, because we don't really have to use our muscles as much anymore as we once did. But it has a huge impact on our metabolic health and our physical functioning.

AUBREY: Now, before he became a physician, Leila, he was a personal trainer. And he says when it comes to muscle strength, it's basically use it or lose it. Exercise, particularly resistance training, is really key. But there's also another important part of the equation, too, and that's what you eat.

FADEL: OK. So it makes sense to me that resistance training, working out is important for muscles, but why diet?

AUBREY: Well, there's protein in all of our cells, including our muscle cells. And our bodies are constantly recycling it. New protein is consistently needed to replace old protein. And since we can't really store it, there's a steady demand for a new supply every day. Nutrition scientists Rachele Pojednic explained to me that the amino acids in these protein-rich foods we eat become the building blocks of the new proteins our bodies need.

RACHELE POJEDNIC: Why it's so important that you eat that protein is there are 20 amino acids that can combine to make protein in your body overall. Nine are what we consider essential. What that means is you have to eat them because your body can't make them.

AUBREY: And if you don't consume enough, you can end up with deficiencies. And this is bad for muscle health.

FADEL: So are most people getting enough protein?

AUBREY: Most young people and young adults tend to eat the recommended amounts of protein. But by middle age and by the 50s and 60s, research shows that about 30% of men and nearly half of women aged 50 and older do not consume enough. And it turns out that as we age, we tend to need more protein. And if you're exercising a lot, which, as we just said, is the way to build new muscle, that can also increase the amount of protein you need. Here's Rachele Pojednic again.

POJEDNIC: So with exercise, you're breaking your muscle tissue down. And then after exercise, you want your muscle to rebuild and regenerate. If you don't have those building blocks around, you're not going to be able to do that. So you have to make sure that you're eating to support your training. And protein is going to provide those building blocks for all the tissues in your body.

FADEL: So how much protein do we need?

AUBREY: Well, the recommended amount is set by the Food and Nutrition Board, which is part of the National Academy of Sciences. It's 0.8 grams, so almost a gram of protein per kilogram of body weight. That means for a 150-pound person, they should consume at least 54g of protein each day. And then by middle age, lots of experts agree we need more, up to 80 or 95 grams for that 150-pound person. People who are hardcore into exercise, people training for endurance events often aim for double the recommended amount.

FADEL: OK, so you just said a lot of numbers, but what does that actually look like on a plate?

AUBREY: (Laughter).

FADEL: And what are the best sources of protein?

AUBREY: Yeah. Meat is a top source of protein. Though, as many people aim to cut back, there are plenty of plant-based alternatives. In fact, a new study published this month found that adequate protein intake in midlife, especially from plant protein, is linked to significantly higher odds of healthy aging. So that's more validation that protein does matter. You know, I've been playing around with a bunch of different combinations of high protein foods that taste good.

I'm using a lot of lentils and chickpeas, both good sources. Greek yogurt is my go-to for breakfast because it's packed with protein. I sprinkle on nuts and seeds into my yogurt and also into my salads. I'm tossing in walnuts, pumpkin seeds. Then when I'm in a hurry, I just take a strained can of tuna, pour it into a big bowl with greens, top it with some parmesan cheese, because hard cheeses have a lot of protein. And it's easy to get 30 or 40 grams of protein in a meal. I've actually been snapping some photos and have posted some online this morning on npr.org. And I'm asking people to share how they're getting protein on the plate, too.

FADEL: OK, so send us your food pics. Allison, I think I'm ahead of the game here with the lentils and chickpeas. I love lentils and chickpeas.

AUBREY: Yeah, it sounds that way.

FADEL: So we've focused a lot on women in this conversation. Why, Allison, are women at higher risk?

AUBREY: Well, men tend to be more muscular than women in general, and women tend to lose muscle faster. There are hormonal changes and other aging-related factors. Also, for reasons that aren't so clear, women tend not to eat as much protein, and this can start even at a young age. One nutrition scientist I spoke to said you can see this in adolescence, boys tend to eat more meat, young women may be steered to salads, so part of it could be cultural. That's beginning to change. But the bottom line is this, Leila, though women are at higher risk of muscle loss, through weight training, resistance training and the diet to support it, women certainly can continue to fend off muscle loss and stay strong. Here's Rachele Pojednic again.

POJEDNIC: You can build muscle up into your 70s, your 80s, your 90s. So hope is not lost as you get older. Just do know that it gets more challenging.

AUBREY: That's why I'm trying to form new habits now, Leila. I used to be all about the cardio, the bike or the StairMaster. But I have swapped this for resistance training three times a week. That's my goal.

FADEL: All right. NPR's Allison Aubrey. Thank you so much.

AUBREY: Thank you, Leila.

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